Forensic Pathology (Autopsy) Report

Group Member #1: Rafael Rosas

Group Member #2:Nayeli Diez de BonillaGroup Member #3 (if applicable):N/ACase File (example, HTH-12): HTH-14I. Cause of Death

What was the cause of death?

The decedent had a weak immune system due to a medication, Humira, that she had been taking for over a year. After contracting an infection, it was able to make its way to her heart, where the bombardment of white blood cells caused cardiac arrest (even without the white blood cells, the infection in her heart would probably have eventually killed her).

What pieces of evidence (from the report or the internet) do you have?

What pieces of evidence (from the report or the internet) do you have?

The decedent was complaining about “tightness in the chest”(2012, Investigative Narrative). She was “pale and cold to the touch”(2012, Investigative Narrative) which was caused by disruption of blood flow in the decedent.

III. Manner of Death

What was the manner of death?

Natural

What pieces of evidence (from the report or the internet) do you have?

The decedent had an unusual build up of white blood cells in her heart. This unusual buildup indicates that her immune system was attacking her heart, most likely to kill an infection that had reached her heart. (2014, Cunha, retrieved from http://www.rxlist.com/humira-side-effects-drug-center.htm)

IV. In 1-2 paragraphs, describe your overall opinion using evidence about how the individual in your case file died.Our case file was about a relatively young wife and mother of two, who died a in San Diego a few hours after landing from a flight which departed from Houston, Texas. After reviewing the Autopsy report and narrative, several things stuck out to us that we believed could help us determine the cause of death. First of all, we registered that our decedent was taken to a minor hospital four days before her death for symptoms that included back pain, nausea and cloudy urine. In addition, the decedent had suffered from severe Psoriasis, a skin condition that causes skin redness and irritation, and had been taking prescription Humira to help fight the Psoriasis for over a year. Our research showed us that some of the side effects of Humira included easy bruising and a weakened immune system. The autopsy showed that there were slight bruise marks over around the knees and ankles, and brown-pink ecchymosis over the left breast. It also showed several grey and purple colored specks scattered across the lungs, and an unnaturally excessive buildup of white blood cells in the heart. Essentially, we had to determine the cause, mechanism, and manner of death. It was relatively easy to determine that the decedent’s manner of death came from a natural cause, as there was no evidence to suggest that it was homicide or suicide (both in the background story and in the autopsy), and the death was not accidental since she was neither intoxicated or drugged during her death, hit by a car, or in any other way accidentally killed. After spending what felt like hours going over every single detail in the autopsy, we determined that the mechanism of death was cardiac arrest. Several pieces of evidence helped us get to this conclusion. First of all, the microscopic examination of the heart was the only part of the autopsy that showed major malfunctions in any of her major organs. Additionally, the decedent was in fact found in cardiac arrest when the ambulance arrived for her at the airport. Finally, the ecchymosis over the left breast was a major clue, as ecchymosisskin discoloration is caused by the escape of blood into the tissue from ruptured blood vessels. The heart is on the left side of the chest, and for the decedent to have shown ecchymosis on her left breast was a major pointer that something had gone wrong within her heart. The third, and most challenging part of this assignment, was identifying the cause of death. Our search began with us asking ourselves what could have caused cardiac arrest. After realizing that the decedent had shown some side effects of Humira (such as the small bruises on her knees and feet), we decided to start our search there. That is when we discovered that another side effect of Humira is a weakened immune system, which would have made it extremely easy for an infection to find it’s way into the decedent’s body. We believe she contracted the infection during the time that we went to a minor emergency clinic after showing symptoms such as back pain, nausea, and cloudy urine (symptoms very common with UTI’s, kidney infections, and several other kinds of infections). Already having a naturally weak immune system made even weaker by the prescription Humira, the infection easily and quickly found its way into the decedent’s heart. Her immune system, trying to fight off the infection, attacked her heart with white blood cells, but instead of destroying the infection, it sent her heart into cardiac arrest and, ultimately, killed her. To sum it all up, the decedent’s manner of death was a natural one, the mechanism of death was cardiac arrest, and the cause of death was her body’s reaction of attacking the infection, that had reached her heart, with white blood cells. On a side note, we believe that if the surplus of white blood cells in her heart had not killed her, the infection eventually would have.